Liver tumors: Monitoring embolization in rabbits with VX2 tumors - transcatheter intraarterial first-pass perfusion MR imaging
Liver tumors: Monitoring embolization in rabbits with VX2 tumors - transcatheter intraarterial first-pass perfusion MR imaging
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DOI：
10.1148/radiol.2451061689
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发表时间：
2007-10-01
期刊：
影响因子：
19.7
通讯作者：
Larson, Andrew C.
中科院分区：
文献类型：
--
作者：
Wang, Dingxin;Bangash, Affaan K.;Larson, Andrew C.
目的：前瞻性检验经导管动脉内首过灌注 (TRIP) 磁共振 (MR) 成像可以描述经导管动脉栓塞 (TAE) 期间兔肝肿瘤灌注连续减少的假设。材料和方法：所有实验均经过机构动物护理和使用委员会批准。在四只兔子中植入八个 VX2 肝脏肿瘤，在传统血管造影引导下将导管放置在肝动脉中。转移到 MR 成像套件后，进行连续 TAE，在每个栓塞阶段注射约 50 万个 40-120 μm 栓塞颗粒。在基线和每个后续栓塞阶段（阶段之间 10 分钟）后进行 TRIP MR 成像。重复连续 TAE 和 TRIP MR 成像直至停滞。在肿瘤和肝动脉中测量信号增强的首次通过时间过程。测量肿瘤曲线下面积 (AUC) 和最大上斜率 (MUS) 值，每个值均通过动脉输入标准化，以评估迭代灌注减少。将 TAE 各阶段的灌注测量结果与配对 t 检验和线性回归进行比较。 结果：TAE 后 AUC 从 TAE 前基线 0.408（95% 置信区间 [CI]：0.330、0.486）下降至 0.065（95% CI：0.046、0.085）（P < .001）。 MUS 从 TAE 前的基线 0.151 (95% Cl: 0.121, 0.181) 降至 TAE 后的 0.027 (95% Cl: 0.022, 0.031) (P < .001)。每个栓塞阶段后 AUC 和 MUS 的降低具有统计学意义（每组配对比较 P < .006）。 AUC 与 MUS 密切相关（r = 0.966，P < .001）。结论：TRIP MR 成像可以描绘 TAE 期间肝脏肿瘤灌注的连续减少。 TRIP MR 成像提供了在 TAE 期间定位功能性栓塞终点的潜力。
Purpose: To prospectively test the hypothesis that transcatheter intraarterial first-pass perfusion (TRIP) magnetic resonance (MR) imaging can depict serial reductions in rabbit liver tumor perfusion during transcatheter arterial embolization (TAE).Materials and Methods: All experiments had institutional animal care and use committee approval. In four rabbits implanted with eight VX2 liver tumors, catheters were positioned in the hepatic arteries with conventional angiographic guidance. After transfer to the MR imaging suite, serial TAE was performed, with approximately 0.5 million 40-120-mu m embolic particles injected at each embolic stage. TRIP MR imaging was performed at baseline and after each subsequent embolic stage (10 minutes between stages). Serial TAE and TRIP MR imaging were repeated until stasis. The first-pass time course of signal enhancement was measured in both tumors and hepatic arteries. Tumor area under the curve (AUC) and maximum upslope (MUS) values, each normalized by arterial input, were measured to assess iterative perfusion reduction. Perfusion measurements across TAE stages were compared with paired t tests and linear regression.Results: AUC decreased from a pre-TAE baseline of 0.408 (95% confidence interval [CI]: 0.330, 0.486) to 0.065 (95% Cl: 0.046, 0.085) (P < .001) after TAE. MUS decreased from a pre-TAE baseline of 0.151 (95% Cl: 0.121, 0.181) to 0.027 (95% Cl: 0.022, 0.031) (P < .001) after TAE. Reductions to AUC and MUS after each embolic stage were statistically significant (P < .006 for each group of paired comparisons). AUC strongly correlated with MUS (r = 0.966, P < .001).Conclusion: TRIP MR imaging can depict serial reductions in liver tumor perfusion during TAE. TRIP MR imaging offers the potential to target functional embolic end points during TAE.